Dementia Answer Sheet Name: Date: Name of Trainer: Name of Company: Clinical Update (NZ) Ltd Segment 1 What does the term dementia mean? Memory loss Name the parts of the brain that are affected with a person with dementia? Parietal, Frontal, Temporal and Occipital Lobes List 5 functions of the Frontal Lobe - Any 5 of these Emotional control centre Personality Motor function Problem solving Spontaneity Memory Initiation Judgment Impulse control Social and sexual behavior List the 2 functions of the Parietal Lode 1.Sensation (cognition) 2. Perception The Occipital Lobe is responsible for Visual illusions or hallucinations Visual distortions Word Blindness In dementia the Temporal Lobe affects a person by Reduced ability to recall verbal or visual content Loss of inhibition Seizures can affect personality, speech, create paranoia & aggressive rages & affect sexual behaviour List the 5 requirements of executive functioning Planning Organizing Strategizing Paying attention to and remembering details Managing time and space. Cognition is the intellectual function of the brain 1
List the 5 requirements of Cognition Thought Reasoning Understanding perception Awareness Conscious judgments Name 5 different types of dementia you see in your workplace Any 5 of these Alzheimer s Disease Vascular Dementia Picks Disease Lewey Body Disease Head Trauma Parkinson s Disease Wernicke-Korsakoff Syndrome (Alcohol Dementia) Huntington s Disease Segment 2 What is the most common form of Dementia? Alzheimer s Disease Alzheimer s disease is a Progressive Disease How long is it likely a person will have Alzheimer s disease before it is diagnosed up to 10 years What age group is this most common in? Over 80 List the risk factors Age Genetic link Downs Syndrome Approximately how long does a person live with Alzheimer s Disease 2 to 25 years Do people die of Alzheimer s Disease? Name the 3 main structures of a neuron Axon Dendrite Nucleus What develops in the brain in Alzheimer s Disease? Plaques and tangles Are these in normal in the aging brain? What is different in the Alzheimer s Brain? There are more plaques and tangles Describe what happens to the brain with the loss of neurons The brain shrivels and withers (or dies) What are the first signs of Alzheimer s Disease? Problems with memory, thinking and concentration 2
List the 10 signs or symptoms of Alzheimer s Disease Memory Loss: Difficulty performing normal tasks Problems with language Disorientation of time & place Poor or decreased judgment Problems with abstract thinking Misplace things or put them in the wrong place Changes in mood & behaviour Changes in personality Loss of initiative Segment 3 Vascular Dementia What is the other name for Vascular Dementia? Multi-Infarct Dementia What is the cause of this Vascular dementia? Result of impaired blood flow to the brain What does TIA mean? Trans Ischaemic Attach What is the difference between a TIA and a Stroke? (explain in your own words) TIA Artery temporarily blocked Stroke Artery fully blocked What are the signs and symptoms of a TIA? Dizziness Loss of balance and co-ordination Trouble walking Drop attacks List 7 symptoms you might see in Vascular Dementia - Any 7 of these Problems with speed of thinking Difficulty concentrating Communication issues Depression & Anxiety Memory problems Seizures Periods of acute confusions Visual mistakes or misperceptions Changes in behaviour Difficulties in walking or unsteady on feet Hallucinations Continence problems Psychological symptoms What are the 2 dementia s that often affect people in mixed dementia? Alzheimer s Disease & Vasculary Dementia Segment 4 Picks Disease What age does this commonly start? 54 years& what sex predominantly get it Females What percentage of cases have a familial link? ½ to 2/3 3
What two areas of the brain are affected in Pick s Disease Frontal lobe Temporal Lobe What are Pick Bodies? Abnormal Proteins called Tau In the latter stages of the disease Picks Disease can resemble? Alzheimer s Disease What parts of the brain does Pick s Disease affect? Frontal Lobe and Temporal Lobe List 4 behaviours commonly seen in people with Pick s Disease any 4 of these Trouble keeping a job Compuslive behaviour Act inappropriately in social situations Neglect hygiene needs Repetition of words and activities Lack of judgement Loss of inhibition Inappropriate sexual behaviour Change in personality List 4 emotional changes commonly seen in Picks Disease. Any 4 of these Mood swings Lose concept of emotional warmth, concern for others, empathy or sympathy Appear selfish and unfeeling Unaware of inappropriate moods changes No thought or care about events Little care for the environment List 4 Language changes commonly seen in Picks Disease. any 4 of these Become Mute Increasing unable to read or write Increasing difficulty in finding right words Loss of ability to start conversation May mimic or copy what you say List the 4 Neurological changes seen in Picks Disease? Loss of muscle tone Rigidity Lack of coordination of movement Increasing memory loss Is incontinence usual in people with Picks Disease? What two things happen with eating for a person with Picks Disease? Over eat Develop a taste for sweet things Segment 5 Lewy Body Disease What are Lewy Bodies? Deposits of protein 4
Lewy Bodies affect the area of the brain in thinking and movement Cognitive problems are similar to what other disease? Alzheimer s Disease Motor problems are similar to what other disease? Parkinson s Disease Lewy Body disease affects people over 60 (what age)and affects mainly Men (sex) Is there a familial link? List 5 motor changes seen in a person with Lewy Body Disease tremors, slowed movement, rigid muscles, shuffling gait, falls What 3 things affect cognition (thought, reasoning, understanding perception or awareness) confusion, memory loss, reduced attention span What may a person with Lewy Body Disease imagine they see? Colours, shapes, people, animals that are not there What sleep disorder may you see in people with Lewy Body Disease? They may act out their dreams Explain how their attention span may be affected. They may be drowsy, stare into space, be lethargic and havedisorganised speech Segment 6 Head Trauma What happens to the brain when it suffers a blow to the head? The brain to move violently within the skull The force of a blow to the head can cause the brain to shake, twist, bruise and cause concussion Head injury can cause changes in _emotions and behaviour Can the brain heal itself? /Sometimes Is the direct injury to the head the major problem? Is No, what are the other problems/complications bleeding, increased fluid collection (hydrocephalus) & infection List 8 symptoms of head injury Problems thinking clearly Memory loss Poor concentration Slowed thought processes Irritability, easily frustrated Impulsive behavior Mood swings Inappropriate behavior in social situations Grooming and dressing eccentric or neglected Restlessness or agitation 5
Insomnia Aggression, combativeness, or hostility headache Fatigue Vague, nonspecific physical symptoms Apathy What are the 6 major long term affects of head injury Depression Anxiety Mania Psychosis Obsessive-compulsive symptoms Suicide risk Segment 7 Parkinson s disease What is Parkinson s Disease a neurological condition affecting movement and what are the 3 characteristics that affect a person Tremors Rigidity Problems with balance and motor skills What percentage of people with Parkinson s Disease will have dementia? 20-60% Name to two other diseases that may be found on autopsy Alzheimer s Disease and Lewy Body Disease List 4 primary symptoms of Parkinson s disease Slowed movement (bradykinaesia) Tremors Rigidity Poor Balance List 6 general secondary symptoms a person will have any 6 of these Constipation Difficulty swallowing Choking or coughing Excessive salivation and sweating Loss of bowl and/or bladder control scaling dry skin on face or scalp Slow response to questions Small cramped handwriting Soft whispery voice List the 8 dementia symptoms people with Parkinson s disease will show. Memory Problems Difficulty retrieving memories Executive function impairment Distractibility Disorientation and confusion Moodiness Lack of motivation and apathy Hallucinations Anxiety, depression & isolation 6
Segment 8 Wernicke-Korsakoff Syndrome What causes alcohol dementia or Korsakoffs Encephalopathy? Excessive drinking of alcohol over many years Alcohol has a direct effect on what organ? Brain cells Explain how alcohol attacks the brain Attacks the forebrain first affects motor co-ordination and decision making Then knocks out the mid-brain lose control over emotions and causes blackouts Finally batters the brain stem affects the heart rate, body temperature, appetite and consciousness List the 4 major affects alcohol will have on the body? any explanation that you are satisfied with Make worse existing intellectual and psychiatric problems Damages nerves in arms and legs that affects sensation (Peripheral Neuropathy) and coordination (cerebellar ataxia) creating unsteadiness on feet Damages heart (cardiomyopathy) and liver (cirrhosis) Causes Stokes and low blood flow to brain List 4 problems that will occur as the result of alcohol abuse any 4 of these Memory Learning Cognitive skills Poor judgment Lack of insight Difficulty making decisions Nutrition problems due to lack Vitamin B What are the 5 characteristics of this Encephalopathy? Damage to multiple nerves in brain and spinal cord and the rest of the body Not a dementia but an amnesia Malnutrition especially Vitamin B1 thiamine deficiency Distinguishing symptom Fabrication of stories A distinct walking gait List 7 signs and symptoms of alcohol abuse any 7 of these Severe short term memory Fabrication of stories Involuntary, jerky eye movements or paralysis of eye muscles Poor balance Staggering gait Inability to walk Drowsiness Confusion Personality changes Segment 9 Huntington s disease Huntington s disease is an inherited condition Children of people with the Huntington s gene have at least a 50% chance of getting it. The affecting gene is called a Dominent gene 7
The disease commonly affects people at what age? 30 s and 40 s How long can the disease before they die 10 and 30 years What chromosome does the disease effect? Chromosome 4 What does the defect cause a particular DNA to do? To repeat itsself What is the usual number of repeats on this chromosome? 10 28 repeats In Huntington s Disease the repeats will be between 36 to 120 times What determines how early the disease will develop in a person the number of repeats ie. The larger the number of repeats, the earlier the disease will develop What influences the age a person will get the disease? As the disease is passed down families the repeats will be rise leading to younger the disease will develop in families What are the 3 ways that Huntington s disease will affect people Cognition Emotion, Movement What are the 3 general primary symptoms of Huntington s disease? Difficulty retrieving memories, Problems with executive functioning, and Impaired judgment. List 4 behavioural signs and symptoms of Huntington s disease? Behavioural disturbances Hallucinations Irritability Moodiness Restlessness and fidgeting Paranoia Psychosis What are the 5 abnormal or unusual movement a person with Huntington s will display? Facial movements, including grimaces Head turning to shift eye position Quick, sudden sometimes wild jerking movements of the arms, legs, face and other body parts Slow uncontrolled movements Unsteady walking gait List the 5 dementia signs and symptoms Disorientation and confusion Loss of judgment Loss of memory Personality changes Speech changes What additional signs and symptoms might you see in a person with Huntington s disease? Anxiety, stress and tension Difficulty swallowing Speech impairment Explain in your own words what the Huntington s brain looks like this or similar The brain gets smaller and develops big gaping holes in the middle and large gaps in the folds on the outer rim of the brain. 8